The Truth about HB 226The Home Birth Safety Act

A publication of the Coalition for Illinois Midwifery

INTRODUCTION: Each year, 800 - 1000 Illinois women, including some from the Amish, Latin MassCatholic, Orthodox Jewish, and other communities, choose to have a home birth for deeply-felt reasons.In most states, a licensed midwife could assist in these home births, but it is illegal in Illinois to assist in ahome birth unless a midwife is also a nurse and practices with a physician. Thus, only about 4 of Illinois'102 counties have a licensed home birth provider, and even in those counties, the demand for homebirthfar surpasses the number of providers.

As a result, an underground industry of unlicensedmidwives currently serves Illinois mothers creating an unsafe situation. HB 226 wouldlicense certified professional midwives, as 26 other states already do, to regulate thismarket and protect Illinois moms who choose home birth, and their babies.

Over the past few months the Illinois State Medical Society (ISMS), and other sub-specialty privatephysician professional groups, distributed materials that we believe misrepresent the facts about HB226 and about the midwives who would be licensed for home birth by HB 226.These Physicians groups offer many false criticisms but absolutely no viable solution. What is their answer to the home birth crisis that Illinois women must face every day? This document was producedto set the record straight about our solution, HB 226, the Midwifery Licensure Act.

In terms of providing care beyond maternity care, yes. But when it comesto providing maternity care throughout prenatal, intrapartum andpostpartum period, CPMs have nearly identical training to nurse-midwiveswith special attention paid to out-of-hospital techniques. This trainingalong with the required additional background education has receivedthe approval of the ISAPN and INA."These midwives are significantly different from certified nurse midwives."

The FactsClaim

ISMS supports the collaborative relationship that currently exists betweenphysicians and certified nurse-midwives."Illinois OB/GYNs support only the

inclusion of the provision

requiringwritten collaboration, not the real-life practice of providing homebirthcollaborative care. As a group, they do NOT support homebirth or homebirth providers, including homebirth nurse-midwives, in spite of thestatute requiring that nurse-midwives secure written and signedagreement with a physician. Nationally, ACOG has officially turned its backon the home birth population, stating, “Although ACOG acknowledges awoman's right to make informed decisions regarding her delivery, ACOGdoes not support programs or individuals that advocate for or who provideout-of-hospital births.”

(

American College of Obstetricians and Gynecologists Executive Board. (2006). "ACOG Statement of Policy on Out of Hospital Births in The United States".October 2006.www.acog.org)

The FactsClaim

Coalition for Illinois MIdwifery Truth About HB 226, pg. 2

"Midwives are asking to ‘prescribe dangerous drugs.’”

There is absolutely no prescriptive authority in this bill.

Licensedmidwives will be allowed to carry and dispense only a tiny number of medications, and only as strictly regulated in the statute. The medicationssection in the bill was written in collaboration with the Illinois Society for Advanced Practice Nursing.

The FactsClaim

As loving parents, we strongly agree licensed midwives should beprepared to deal with emergencies. That is why HB 226 would onlylicense nationally certified midwives whose training includes continuoushands-on, one-on-one care throughout labor to anticipate potentialproblems and help prevent them or deal with them as they emerge.National rates of

emergency

transfer of care during labor or right after thebirth, for Certified Professional Midwives, were only 3%, and goodoutcomes were achieved in the majority of instances. The fact is CPMsare trained in the same way as nurse-midwives to identify complicationsand call for transport. CPMs are educated to carry oxygen and drugs for possible hemorrhage just like nurse-midwives, and are also trainedin CPR and Neonatal resuscitation including use of oxygen, just likenurse-midwives (often attending these specialty classes taught by theAmerican Academy of Pediatrics and American Heart Associationinstructors, together

with

nurse-midwives.)

The FactsClaim

“These

midwives will not be prepared to deal with emergencies.”

The FactsClaim

Licensed midwives would NOT be practicing obstetrics but professionalmidwifery -- an entirely different profession for which licensed midwivesunder the statute would be fully prepared. Licensed midwives would

not

perform hundreds of complicated medical procedures (like surgicaltreatment for fibroids, screening for breast cancer or prescribing literallyhundreds and hundreds of

truly

dangerous drugs) for which OB/GYNsmust be prepared. Physicians and nurse midwives almost uniformly DONOT attend homebirth. Far too often it is neighbors, church ladies andfriends who deliver babies at home in Illinois.

Passing HB 226 bill is notabout lowering standards; it will increase current “standards”

from thethe level of a neighbor, friend or church lady to a nationally certified, well-trained midwife who could could legally practice in 26 other states."Passing HB 226 bill is comparable to ... lowering the standards for alicensed obstetrician.”